ALRANZ tonight applauded the Court of Appeal judgment in the long-running anti-abortion court case as a victory for the reproductive rights of all New Zealand women.

“Today’s ruling issued by the Court of Appeal rejected a series of legal challenges to abortion access in New Zealand by the anti-abortion group Right to Life, which began in 2005,” ALRANZ president Dr. Morgan Healey said tonight.

“ALRANZ is heartened by the ruling, which will bring some peace of mind to both women seeking abortion care and doctors who help provide it,” she said.

The anti-abortion group’s claim that the fetus has a right to life under New Zealand law was firmly rejected by the court, as was the 2008 ruling by Justice Miller that there was “reason to doubt the lawfulness of many abortions”, she said.

Dr. Healey said that in rejecting the 2008 ruling, the court has ensured that doctors can’t be pressured or second-guessed over authorizing abortions.

“This is crucial for ensuring women continue to have abortion access under our criminalised abortion system,” she said.

Under New Zealand law, two certifying consultants must approve every abortion under limited grounds set out in the Crimes Act. Right to Life argued that many abortions were wrongly approved under the mental health ground, and claimed that the Abortion Supervisory Committee wasn’t doing enough to ensure the law was being complied with.

“The court has rejected those arguments, protecting the medical integrity of doctors and the work of the Abortion Supervisory Committee,” Dr. Healey said.

However, the fact that our law is constantly facing these kinds of legal challenges speaks to the need for abortion to be decriminalized in New Zealand, she said.

Malaysia in the Asian context
The Malaysian situation clearly doesn’t have the urgency that is seen in other countries in Asia in such as India, Nepal, Indonesia or the Philippines where the high mortality and morbidity rates from unsafe abortions provide a dramatic argument for change.

This is seen for example, in our low MMR (<15/100,000) and our low mortality rates for abortion complications (2-5/year).

Malaysia is seen as a very progressive nation with good living standards, health care, and infrastructure; the iconic Petronas Twin Towers stands in the heart of KL, our capital city. Women have free access to education and high career achievements as ministers and CEOs which says a lot for the progress we have made in social development.

Other indicators are however a matter of concern –e.g. the incidence of teen pregnancies remains high, and contraceptive prevalence rate is low. As pointed out by Prof. Low in her article, social changes taking place in Malaysia has made teen pregnancies a very visible problem. This has resulted in the recent media hype over teen pregnancies and baby ‘dumping’.

But, like many economically developed countries, as in the USA, the stigma attached to abortion makes it the last ‘right’ for women to achieve in terms of equality in decision making and control of her own bodies and their sexuality.

Abortion within the Medical Fraternity
As a young doctor, I was truly puzzled over the medical profession’s irrational attitude to women’s sexual and reproductive health issues; evident from their early objections to the pill and IUCD as posing a danger to women ‘abusing their freedom’. A similar situation has now arisen over the introduction of medical abortion with mifepristone and misoprostol.

The stigmatization of abortion has made efforts to open up this issue, a long and difficult journey. Trying to bring up the subject for rational discussion, until recently, was virtually impossible, even within medical circles. This is despite the overwhelming evidence that abortion is widely available and practiced here.

Surprisingly, even doctors who provided abortions ‘on the quiet’ were ignorant of the penal code on abortion, amended in 1989. A survey done by RRAAM in 2008 revealed that only 57% of doctors and nurses knew the law and while a survey of client seeking abortions, more than half thought it was illegal.

A recent experience with a colleague illustrated this point dramatically; an O&G in charge of a local maternity home who performed occasional abortions came to me in great distress; he had dismissed a nurse for misconduct and she had then threatened to ‘expose’ him. I was surprised he had never bothered to examine the penal code on abortion until I brought it up!

Situation in the 70’s
In the 70s, the concern for abortion access came not from statistics (there were none) but from grassroots healthcare providers who meet women faced with unwanted pregnancies daily. Those facts were evident in my early years as a family planning volunteer. But somehow most women then found a way out, often by accessing competent abortion providers which presumably accounted for the relatively low complication rates.

Exploitation by the profession
At that time, the penal code permitted abortion only ’to save the mother’s life’ (1971). However, as happens everywhere else, it was available for anyone who could afford it, often at exorbitant fees. While working as a consultant anaesthetist in private hospitals it became obvious to me that fees for abortions were often ‘disproportionate’ in relation to other similar procedure. (That was my main occupation for the 8 years of my professional life). At that time all abortions were D&Cs performed under a general anaesthetic.

Sneaking in Abortion Services via MR
In the 60s, the Karman Cannula had been established as a cheaper safer method for abortion under local anaesthetic, but it remained untapped in Malaysia until in the mid 70s, when the late Prof I. S. Puvan of University Malaya had the vision to see its potential and decided to introduce it as ‘menstrual regulation’ (called MR) thus by-passing the penal code by performing the procedure in early pregnancy without confirming it with a urine pregnancy test.

Thus in the mid 70s, as a result of his position and influence, MR gained some acceptance as a legal way of providing abortions. It was even practiced at certain government clinics officially for a time. Sadly, it was not taken up in a big way but MRs remained a low key service provided by some private clinics with charges remaining high.

FFPAM1 and Abortion services in Penang
Although the IPPF supported this move and introduced it to the Family Planning Associations of Malaysia (FFPAM), it was never taken up because of the sentiment of the grass roots members. However, on Prof Puvan’s advice, I agreed to set up a service in my group GP practice in Penang for the equivalent of US$20/- when the standard charge was then US$100/-.

As it happened, the demand for MR services raised so quickly that within a year my GP services were discontinued to focus on abortions for unintended pregnancies and post abortion contraception. Some government objections to my ‘open’ concept abortion clinic were expected, but none came. Actually, from the legal records, no doctor in Malaysia had ever been charged for performing an uncomplicated early abortion, even though, under the 1971 penal code, they clearly breached the law.

Legal Reform and after
There was a breakthrough in legal reform in 1989, when more abortion complications surfaced through the media, possibly one effect of urbanization and the need for smaller families. The clause added in was in line with the British Penal Code that they had amended in 1957 which is to allow abortion for threat of injury to the ‘mental or physical health of the woman’.

Many of us heaved a sigh of relief and I had hoped this was the cue for the family planning associations to take a leading role in providing this service; at that time I was in the executive council of the Federation of FPAs Malaysia, later becoming chairman (1992-6). Despite all my efforts, this never came through; such was the conservative sentiment amongst members at the time.

New Players in Abortion Advocacy
From FIGO, Ipas to RRAAM
There were few developments in advocacy in Malaysia until the FIGO conference took place in Malaysia in 2006 and the APCRSH/FFPAM conference a year later. Prof Anibal Faundes, a past president of FIGO, made a strong stand on the blight of unsafe abortions and the absolute need to recognize it as a major factor in women’s health, in consonance with her basic human rights. At those conferences, Ipas was promoting their safe abortion initiatives while the Asian-pacific Research and Resource centre for Women (ARROW), through an initiative by Ms Rashidah Abdullah, had put up a side symposium to address unmet needs in Malaysia.

All this together created an opportunity to discuss with Ipas the possibility of a project to address the abortion issue; the coalition was formally started in 2007 drawing members who had been activists working directly or indirectly with the family planning associations. Called the Reproductive Rights Advocacy Alliance Malaysia (RRAAM), it was committed to promoting women’s reproductive rights and services (particularly, to contraceptive access for youths and marginalized groups and to safe abortions).

From ICMA, IPPF to ASAP
Further developments were initiated in 2008 when International Consortium on Medical Abortion (ICMA) and IPPF (ESEAOR) organized a regional forum on abortion access in Kuala Lumpur. Major players in reproductive health from 15 countries attended including some donor agencies to discuss and share ideas on the situation in Asia.

The members at the meeting concluded that while different countries faced different obstacles in making safe abortion assessable, there were many individual activists and agencies promoting the same cause in each country. However, there was no central coordinating group that could harness the different experiences to help each other. This became the rationale for creating the new coalition. The Asia Safe Abortion Partnership (ASAP) was thus formed to provide an active network of advocates.

For RRAAM, this provided us opportunity to become part of a regional and global movement. The network has obviously benefited members through it regular email forums, organizing workshops in abortion technology, advocacy strategies and values clarification. But apart from this, the realization of being members of an international movement has significant internal and external impacts.

Speaking for RRAAM members, we have broken out of a shell that labeled us as an isolated ‘eccentric non-conformist group’ and for the general public, RRAAM is now seen as part of an international movement in sync with the efforts of international agencies like IPPF, ICMA, Ipas, Gynuity, etc. and prominent regional players from Vietnam to Nepal. The gratifying response to the joint ASAP/RRAAM seminar on Abortion Access in January 2011 in Kuala Lumpur is, I believe, a testimony to this.

Late last week The New Times reported the arrest of two women, Clemence Yezakuzwe and Chantal Nyirandengayobagira, after they underwent abortions.

These two women, aged 25 and 21 respectively, have fallen foul of our criminal code which makes abortion illegal unless it’s carried out to save the life of the mother, and is supervised by a trained medical officer.

Ms.Nyirandengayo-bagira is currently in hospital after she developed complications and started hemorrhaging profusely.

Police in her home district of Rutsiro, say that she will be charged with murder as soon as she’s back on her feet. The same fate awaits Ms. Yezakuzwe.

The two have differing reasons for undergoing the dangerous operation; Nyirandengayobagira because her husband had abandoned her and Yezakuzwe says she simply wasn’t ready for a baby.

We cannot doubt that they indeed participated in this illegal activity; however I cannot simply say “they broke the law, they deserve the wrath of it”. I find the law itself harsh, unenforceable, mistaken and morally wrong.

Abortion is frowned upon in so many countries because of the belief that human life begins at conception.

So, in other words, as soon as the egg is fertilized and attached itself to the uterine walls, human life has begun. A life that must be protected by the society it finds itself in.

But this begs a few questions that I feel must be answered by our law makers.

Does life really begin at the moment of conception? Or at some other period later on, is it in the second trimester or just in the third?

Presently Rwandan law does not make this distinction and as a result abortion can be exactly what a judge and prosecutor think it is.

This is extremely dangerous especially with the increased use of the Morning-After pill. This contraceptive, used not later than three days after unprotected sex, induces a miscarriage.

Women who use this pill, which is readily available in Rwandan pharmacies, to stop them getting pregnant are, at least according to Rwandan law, if it’s followed to the letter, guilty of abortion.

The new criminal code, which has still not been passed by the Parliament, has to carefully define exactly what the criminal definition of ‘abortion’ is.

To keep it ambiguous is dangerous and will put women in unnecessary collisions with the law.

From time immemorial abortion has been part of the human experience and, while it’s been frowned upon for just as long, it’s never become an outdated practice. There, surely, must be a reason for this.

Carrying a baby to term, giving birth to it and then raising it is hard work. Once that choice is made one’s life is forever altered, your life now revolves around another human being who is helpless without you.

That kind of responsibility is huge and should not be taken lightly and if a woman, for whatever reason, feels that she’s not able to handle it, who are we to tell her that she must? Are we punishing her because she dared have sex?

When one realizes that most of our laws are made by men, living in patriarchal societies, I begin to suspect that controlling female sexuality is the hidden goal of these anti-abortion laws.

While we might pretend that we are protecting the interests of the child, are we really? How is it in the best interests of the child to be raised in a household that doesn’t love him/her? Or simply can’t cater for its needs?

Raising a child in a loving household is hard enough; imagine doing it after your husband has abandoned you? Are we to further punish women because they aren’t able or ready to have a child? Where is our compassion?

What does it say about my society that a woman is dragged from a hospital bed to a jail cell?

In this religious nation (to think otherwise is silly) legalizing abortions will probably cause a big fuss. But to bury our heads in the sand and refuse to see that abortions are happening all the time, is irresponsible.

Why not get off our moral high horses and make sure that our precious women have the best medical care they can get? That would be the Christian thing to do.

The number of newborn babies in Hungary fell 6.3% to 90,350 last year, according to official data. The government is determined to boost this number and put Hungary ’s population back above 10 million. Contrary to original proposal, the new Hungarian constitution won’t ban abortion. Still, the country’s government wants to see more children and will use other means than a constitutional ban on abortion to achieve it. It has so far cut income taxes for parents and extended maternity leave to three years from two. It plans more places at kindergartens and considers granting extra voting rights to parents.

EP President considers MEP question concerning women rights to abortion inadmissible. Using in an arbitrary manner the rules of procedure of European Parliament, the President Buzek deemed inadmissible the question of SYRIZA (GUE/NGL) Member of Parliament Mr. N. Chountis, referring to the resolution of the Council of Europe on abortion. At 7th of October 2010 the Parliamentary Assembly of Council of Europe adopted a resolution titled “the right to conscientious objection in lawful medical care” (1763/2010). In this resolution is mentioned “No person, hospital or institution shall be coerced, held liable or discriminated against in any manner because of a refusal to perform, accommodate, assist or submit to an abortion, the performance of a human miscarriage, or euthanasia or any act which could cause the death of a human fetus or embryo, for any reason.” The MEP questioned about what is the Commissions position in relation to the mentioned resolution and he asked which measures will the Commission take in order to prevent the prevalence of extreme conservative views on the pretext of freedom of conscience are trying to restrict the women rights. The question was deemed inadmissible by thePolish Christian Democrat President of the European Parliament, Mr Buzek. This incident adds to our concerns with the deteriorating situation for SRHR in the European Parliament. ASTRA Network believes that Mr Buzek’s behaviour represents dangerous signal regarding SRHR across the EU.